Please print this form and send it with your deposit*/full payment# to:


Christina Elvin Consultancy, 

12 Kimble Close, Northampton, NN4 0RF, England

Cheques to be made payable to "Christina Elvin"

 

 

FULL NAME  …………………………………………………………………………………….………

ADDRESS ………………………………………………………………………………………………

 ………………………………………………………………………………………………….…….…

POSTCODE  ………………..…  E-MAIL   …………………….……………………………….……     

BUSINESS TEL  …………………………  HOME/MOB TEL ……………………………………..  

PRACTICE ……………………………………...……………………………………………………..…

WHICH COURSE/TRAINING DO YOU WANT TO ENROL FOR ? (Name, Location & Start Date)

 

WHERE DID YOU HEAR OF THIS COURSE? ………………………………………………

REASONS FOR WISHING TO TAKE THIS COURSE

 

I ENCLOSE:

Deposit of*…………………………….…    OR      The full fee# of....………………………….……


Signed……………..………………………………………………………………………

 

Date………………………………..…

Do you have any special dietary requests?   …………………………………………………………..

Any other information you wish us to know? ……………………………………………………………

*£50.00 non-refundable deposit per workshop/training to be paid with this form with the outstanding amount DUE 6 weeks BEFORE the training

# Full amount to be paid when booking IF LESS than 6 weeks before the training